Brand Name | 24MM BASEPLATE, 10 FULL AUGMENT |
Type of Device | SHOULDER PROSTHESIS, REVERSE CONFIGURATION |
Manufacturer (Section D) |
ARTHREX, INC. |
1370 creekside boulevard |
naples FL 34108 1945 |
|
Manufacturer (Section G) |
ARTHREX, INC. |
1370 creekside boulevard |
|
naples FL 34108 1945 |
|
Manufacturer Contact |
|
MDR Report Key | 11484215 |
MDR Text Key | 239787183 |
Report Number | 1220246-2021-02733 |
Device Sequence Number | 1 |
Product Code |
PHX
|
UDI-Device Identifier | 00888867341630 |
UDI-Public | 00888867341630 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | K193372 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
user facility |
Reporter Occupation |
Administrator/Supervisor
|
Type of Report
| Initial |
Report Date |
03/15/2021 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 03/15/2021 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Operator |
Health Professional
|
Device Model Number | 24MM BASEPLATE, 10° FULL AUGMENT |
Device Catalogue Number | AR-9580-2410 |
Device Lot Number | 04521947 |
Was Device Available for Evaluation? |
No
|
Date Manufacturer Received | 02/24/2021 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Other;
|
|
|